Suou T, Yamada S, Kobayashi J, Hoshino U, Nishimuki E, Kawasaki H
Second Department of Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
Hepatology. 1993 Oct;18(4):809-15. doi: 10.1002/hep.1840180410.
To evaluate the mechanism of increased serum concentrations of the N-terminal propeptide of type III procollagen and the 7S fragment of type IV collagen in acute liver injury, we serially measured serum levels of these substances after transcatheter arterial embolization in patients with hepatocellular carcinoma. The results demonstrated marked increases in serum levels of the 7S fragment of type IV collagen in accordance with increased serum levels of transaminase after transcatheter arterial embolization. In contrast, a transient decrease in serum levels of the N-terminal propeptide of type III procollagen was found after transcatheter arterial embolization and transcatheter arterial infusion, although no significant changes in serum levels of the N-terminal propeptide and 7S fragment were seen after hepatic arteriography alone. The absolute change in serum levels of the 7S fragment after treatment showed positive correlation with serum transaminase levels and negative correlation with the decrease in serum levels of alpha-fetoprotein, although serum levels of N-terminal peptide did not demonstrate such a correlation. The results suggest that in acute liver injury induced by transcatheter arterial embolization, at least in part, increased in serum levels of the 7S fragment of type IV collagen reflect accelerated liberation of type IV collagen from the destroyed surrounding nontumorous tissues and that decreased serum N-terminal propeptide of type III procollagen reflects diminished synthesis of type III collagen caused by anticancer drugs.
为评估急性肝损伤时血清III型前胶原N端前肽和IV型胶原7S片段浓度升高的机制,我们对肝细胞癌患者行经导管动脉栓塞术后连续测定了这些物质的血清水平。结果显示,经导管动脉栓塞术后,随着血清转氨酶水平升高,IV型胶原7S片段的血清水平显著升高。相比之下,经导管动脉栓塞术和经导管动脉灌注术后,III型前胶原N端前肽的血清水平出现短暂下降,而单纯肝动脉造影术后,N端前肽和7S片段的血清水平未见明显变化。治疗后7S片段血清水平的绝对变化与血清转氨酶水平呈正相关,与甲胎蛋白血清水平的下降呈负相关,而N端肽的血清水平未显示出这种相关性。结果表明,在经导管动脉栓塞诱导的急性肝损伤中,至少部分IV型胶原7S片段血清水平的升高反映了IV型胶原从周围受损的非肿瘤组织中加速释放,而III型前胶原N端前肽血清水平的降低反映了抗癌药物导致III型胶原合成减少。